AHIP 2026 QUESTIONS AND VERIFIED
ANSWERS; GET IT 100% ACCURATE
A client wants to give you an enrollment application on
October 1 before the beginning of the Annual Election
Period because he is leaving on vacation for two weeks
and does not want to forget about turning it in. What
should you tell him? - correct answer- You
must tell him you are not permitted to take the form. If he
sends the form directly to the plan, the plan will process
the enrollment on the day the Annual Election Period
begins.
ABC is a Medicare Advantage (MA) plan sponsor. It would
like to use its enrollees' information to market non-health
related products such as life insurance and annuities.
Which statement best describes ABC's obligation to its
enrollees regarding marketing such products? -
correct answer- It must obtain a HIPAA
compliant authorization from an enrollee that indicates
the plan or plan sponsor may use their information for
marketing purposes.
,Agent Higgins helps Mrs. O'Malley to enroll in AB
Medicare Advantage (MA) plan during the Annual Open
Enrollment Period. Mrs. O'Malley's effective enrollment
date is January 1st. Subsequently, Mrs. O'Malley
disenrolls on February 12th following a move outside the
plan's service area. What impact will this have on Agent
Higgins compensation? - correct answer- AB
MA PLAN does not have to recoup Agent Higgins
compensation because she has moved away from the
service area.
Agent John Miller is meeting with Jerry Smith, a new
prospect. Jerry is currently enrolled in Medicare Parts A
and B. Jerry has also purchased a Medicare Supplement
(Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How
would you advise Agent John Miller to proceed? -
correct answer- Tell prospect Jerry Smith that he
should consider adding a standalone Part D prescription
drug coverage policy to his present coverage
Agent Lopez helps Ralph to enroll in Top Choice Medicare
Advantage plan during the Annual Open Enrollment
Period. Ralph's effective enrollment date is January 1st.
,Ralph disenrolls on February 12th because he discovers
that the plan did not cover services furnished by several
of his longtime providers. Which of the following
statements best describes the impact of Ralph's action
upon Agent Lopez's compensation? - correct
answer- Agent Lopez's entire compensation must
be recouped because Ralph disenrolled within 3 months
of enrollment.
Agent Mendez wishes to solicit Medicare Advantage
prospects through email and asks you for advice as to
whether this is possible. What should you tell her? -
correct answer- Marketing representatives may
initiate electronic contact through e-mail but an opt-out
process must be provided.
Alice is a marketing representative employed by a health
plan. Betty is a captive agent of a health plan who markets
for multiple plans and sponsors. Carl is a captive agent
who markets to only one plan/sponsor. Denise is an
independent agent who markets to different types of
groups. Edward is an independent agent who markets
only to employer and union groups. CMS marketing
representative compensation rules generally apply to: -
, correct answer- Betty and Denise, but not Alice
(the employee) or Carl or Edward (to whom exceptions
apply).
Angel is new to the Medicare marketplace having
previously been focused on life insurance and disability
income protection products. He intends to conduct an
educational seminar during the AEP at a local hotel and
then invite those who attend to a subsequent marketing
meeting to discuss the benefits of next year's plans. How
would you advise Angel? - correct answer-
Angel should conduct the education seminar as an early
morning meeting and the marketing meeting on the
following day in the late afternoon so that there are at
least 12 hours between the two meetings.
Another agent you know has engaged in misconduct that
has been verified by the plan she represented. What sort
of penalty might the plan impose on this individual? -
correct answer- The plan may withhold
commission, require retraining, report the misconduct to
a state department of insurance or terminate the
contract.
ANSWERS; GET IT 100% ACCURATE
A client wants to give you an enrollment application on
October 1 before the beginning of the Annual Election
Period because he is leaving on vacation for two weeks
and does not want to forget about turning it in. What
should you tell him? - correct answer- You
must tell him you are not permitted to take the form. If he
sends the form directly to the plan, the plan will process
the enrollment on the day the Annual Election Period
begins.
ABC is a Medicare Advantage (MA) plan sponsor. It would
like to use its enrollees' information to market non-health
related products such as life insurance and annuities.
Which statement best describes ABC's obligation to its
enrollees regarding marketing such products? -
correct answer- It must obtain a HIPAA
compliant authorization from an enrollee that indicates
the plan or plan sponsor may use their information for
marketing purposes.
,Agent Higgins helps Mrs. O'Malley to enroll in AB
Medicare Advantage (MA) plan during the Annual Open
Enrollment Period. Mrs. O'Malley's effective enrollment
date is January 1st. Subsequently, Mrs. O'Malley
disenrolls on February 12th following a move outside the
plan's service area. What impact will this have on Agent
Higgins compensation? - correct answer- AB
MA PLAN does not have to recoup Agent Higgins
compensation because she has moved away from the
service area.
Agent John Miller is meeting with Jerry Smith, a new
prospect. Jerry is currently enrolled in Medicare Parts A
and B. Jerry has also purchased a Medicare Supplement
(Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How
would you advise Agent John Miller to proceed? -
correct answer- Tell prospect Jerry Smith that he
should consider adding a standalone Part D prescription
drug coverage policy to his present coverage
Agent Lopez helps Ralph to enroll in Top Choice Medicare
Advantage plan during the Annual Open Enrollment
Period. Ralph's effective enrollment date is January 1st.
,Ralph disenrolls on February 12th because he discovers
that the plan did not cover services furnished by several
of his longtime providers. Which of the following
statements best describes the impact of Ralph's action
upon Agent Lopez's compensation? - correct
answer- Agent Lopez's entire compensation must
be recouped because Ralph disenrolled within 3 months
of enrollment.
Agent Mendez wishes to solicit Medicare Advantage
prospects through email and asks you for advice as to
whether this is possible. What should you tell her? -
correct answer- Marketing representatives may
initiate electronic contact through e-mail but an opt-out
process must be provided.
Alice is a marketing representative employed by a health
plan. Betty is a captive agent of a health plan who markets
for multiple plans and sponsors. Carl is a captive agent
who markets to only one plan/sponsor. Denise is an
independent agent who markets to different types of
groups. Edward is an independent agent who markets
only to employer and union groups. CMS marketing
representative compensation rules generally apply to: -
, correct answer- Betty and Denise, but not Alice
(the employee) or Carl or Edward (to whom exceptions
apply).
Angel is new to the Medicare marketplace having
previously been focused on life insurance and disability
income protection products. He intends to conduct an
educational seminar during the AEP at a local hotel and
then invite those who attend to a subsequent marketing
meeting to discuss the benefits of next year's plans. How
would you advise Angel? - correct answer-
Angel should conduct the education seminar as an early
morning meeting and the marketing meeting on the
following day in the late afternoon so that there are at
least 12 hours between the two meetings.
Another agent you know has engaged in misconduct that
has been verified by the plan she represented. What sort
of penalty might the plan impose on this individual? -
correct answer- The plan may withhold
commission, require retraining, report the misconduct to
a state department of insurance or terminate the
contract.
